Purpose: The purpose of this study was to evaluate the clinical outcomes and compare complication rates for patients with prostate cancer treated with iodine 125 ((125)I) and palladium 103 ((103)Pd) prostate brachytherapy at a single institution.
Patients And Methods: Between 1992 and 2002, 272 patients with prostate cancer were treated with ultrasound-guided transperineal implantation incorporating (125)I (107 patients) or (103)Pd (165 patients). Three months of hormonal therapy was incorporated into the treatment program in 33% of the patients in both groups. Nineteen percent of those treated with (125)I were treated with a combination of implantation plus external-beam radiation therapy. Only 6% of the group receiving (103)Pd implants were treated with such a combination. For those treated with (125)I implantation alone, the minimum tumor dose was 145 Gy. The minimum tumor dose for those treated with (103)Pd alone was 125 Gy. Those treated with a combination of external-beam radiation therapy and (125)I received 45 Gy via 1.8-Gy fractions followed by implantation with a minimum tumor dose of 110 Gy. For those treated with external-beam radiation therapy and (103)Pd, the doses were 45 Gy via 1.8-Gy fractions followed by implantation with minimum tumor dose of 98 Gy. Outcomes were evaluated based on radionuclide used, T stage, Gleason score, prostate-specific antigen, and prognostic group. Complications were also evaluated for each radionuclide. The mean follow-up for the (125)I group was 55 months, and the range was 12-108 months. The mean follow-up for the (103)Pd group was 44 months, and the range was 12-72 months.
Results: The 5-year biochemical disease-free survival rates for those in the favorable group (clinical stage T1c or T2, prostate-specific antigen level <10, Gleason score <7) were 92% for the (125)I group and 92% for the patients treated with (103)Pd. The 5-year disease-free survival rates for those in the intermediate and poor prognostic groups, which were combined, was 72% and 74%, respectively, for (125)I and (103)Pd. There was no statistically significant difference for either modality for any treatment group tested. In those treated with implantation alone, patients treated with (125)I had higher complication rates than those treated with (103)Pd (15% vs 4%). (125)I-treated patients had a grade 2 complication rate of 8% and a grade 3-4 complication rate of 7%, compared with 3% and 1%, respectively, for the (103)Pd-treated patients.
Conclusion: Despite the different management recommendations that evolved during the study period, the clinical outcome for patients treated with either radionuclide were similar with respect to biochemical disease-free survival. Although specific dosimetric comparisons are not valid given differences in imaging over the study course, the complication rate appears to be somewhat higher for (125)I, which is consistent with a radiobiologic model.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1097/00130404-200405000-00006 | DOI Listing |
Pharm Dev Technol
December 2024
Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
The increasing prevalence of dental pathogens and oral cancer calls for new therapeutic agents. Nanoparticle (NPs) based tumor therapy enables precise targeting and controlled drug release, improving anti-cancer treatment efficacy while reducing systemic toxicity. Zinc oxide NPs (ZnO NPs) are notable in nanomedicine for their exceptional physicochemical and biological properties.
View Article and Find Full Text PDFWorld J Gastrointest Surg
December 2024
Department of General Surgery, Hospital General de Requena, Requena 46340, Spain.
The debate regarding the two possible roles of lymphadenectomy in surgical oncology, prognostic or therapeutic, is still ongoing. Furthermore, the use of lymphadenectomy as a proxy for the quality of the surgical procedure is another feature of discussion. Nevertheless, this reckoning depends on patient conditions, aggressiveness of the tumor, the surgeon, and the pathologist, and then it is not an absolute surrogate for the surgical quality.
View Article and Find Full Text PDFMikrochim Acta
December 2024
School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, Guangdong, China.
Time-resolved fluorescence immunochromatographic test strips (TRFIS) was developed for the rapid detection of hepatocellular carcinoma (HCC)-specific plasma exosomes (hExos) by targeting the hExo-surface membrane protein glypican-3 (GPC3). The GPC3-TRFIS could directly detect plasma exosomes without the isolation and purification process, and the whole immunoassay could be completed within 15 min. The visual detection limit of GPC3-TRFIS was 3.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, Hebei, China.
Objectives: To explore the effect of mild cognitive impairment (MCI) and MCI with sleep disorders on the potency of sevoflurane anesthesia in the elderly.
Design: Prospective study methods. Dixon up-and-down methods.
BMC Med Res Methodol
December 2024
Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Background: The aim of this study is to develop a method we call "cost mining" to unravel cost variation and identify cost drivers by modelling integrated patient pathways from primary care to the palliative care setting. This approach fills an urgent need to quantify financial strains on healthcare systems, particularly for colorectal cancer, which is the most expensive cancer in Australia, and the second most expensive cancer globally.
Methods: We developed and published a customized algorithm that dynamically estimates and visualizes the mean, minimum, and total costs of care at the patient level, by aggregating activity-based healthcare system costs (e.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!